Bottom Line:
AF is also known to be associated with an increased risk of adverse events such as transient ischemic attack, ischemic stroke, systemic embolism, and death.This association is enhanced in select populations with preexisting comorbid conditions such as chronic heart failure.The aim of this review is to highlight the advances in the field of cardiology in the management of AF in both acute and long-term settings.

ABSTRACTAtrial fibrillation (AF) is the most commonly encountered arrhythmia in clinical practice. Aging populations coupled with improved outcomes for many chronic medical conditions has led to increases in AF diagnoses. AF is also known to be associated with an increased risk of adverse events such as transient ischemic attack, ischemic stroke, systemic embolism, and death. This association is enhanced in select populations with preexisting comorbid conditions such as chronic heart failure. The aim of this review is to highlight the advances in the field of cardiology in the management of AF in both acute and long-term settings. We will also review the evolution of anticoagulation management over the past few years and landmark trials in the development of novel oral anticoagulants (NOACs), reversal agents for new NOACs, nonpharmacological options to anticoagulation therapy, and the role of implantable loop recorder in AF management.

Figure 1: Acute Management of new onset atrial fibrillation (LAA: Left atrial appendage; Full anticoagulation: either with 4 consecutive weeks of warfarin therapy with weekly therapeutic INR (2-3) or four weeks of the novel oral anticoagulants (NOACs) without any interruption even for one dose

Mentions:
In the absence of hemodynamic compromise the management of AF is guided by symptomatology and its duration [Figure 1]. This specifically involves identifying exercise capacity and functional capacity, which is inferred from generalized complaints of fatigue and the absence or presence of syncope. Establishing the presence or absence of symptoms and their duration in AF patients is paramount in making decisions regarding long-term rate versus rhythm control strategy. Lastly, it is important to identify and effectively manage other risk factors such as obesity, thyroid disorder, and sleep apnea.

Figure 1: Acute Management of new onset atrial fibrillation (LAA: Left atrial appendage; Full anticoagulation: either with 4 consecutive weeks of warfarin therapy with weekly therapeutic INR (2-3) or four weeks of the novel oral anticoagulants (NOACs) without any interruption even for one dose

Mentions:
In the absence of hemodynamic compromise the management of AF is guided by symptomatology and its duration [Figure 1]. This specifically involves identifying exercise capacity and functional capacity, which is inferred from generalized complaints of fatigue and the absence or presence of syncope. Establishing the presence or absence of symptoms and their duration in AF patients is paramount in making decisions regarding long-term rate versus rhythm control strategy. Lastly, it is important to identify and effectively manage other risk factors such as obesity, thyroid disorder, and sleep apnea.

Bottom Line:
AF is also known to be associated with an increased risk of adverse events such as transient ischemic attack, ischemic stroke, systemic embolism, and death.This association is enhanced in select populations with preexisting comorbid conditions such as chronic heart failure.The aim of this review is to highlight the advances in the field of cardiology in the management of AF in both acute and long-term settings.

ABSTRACTAtrial fibrillation (AF) is the most commonly encountered arrhythmia in clinical practice. Aging populations coupled with improved outcomes for many chronic medical conditions has led to increases in AF diagnoses. AF is also known to be associated with an increased risk of adverse events such as transient ischemic attack, ischemic stroke, systemic embolism, and death. This association is enhanced in select populations with preexisting comorbid conditions such as chronic heart failure. The aim of this review is to highlight the advances in the field of cardiology in the management of AF in both acute and long-term settings. We will also review the evolution of anticoagulation management over the past few years and landmark trials in the development of novel oral anticoagulants (NOACs), reversal agents for new NOACs, nonpharmacological options to anticoagulation therapy, and the role of implantable loop recorder in AF management.